Elders deserve plan for future

By Noelle Merrill, Special to the BDN •August 3, 2009 5:30 pm

July 1, an ominous date for the residents of seven affordable assisted living facilities whose MaineCare services were in danger of being cut, has come and gone. This state-imposed deadline for the MaineCare “rule change” was a stressful time for Eastern Area Agency on Aging, which provides the services at three of the facilities. It was also a terrifying time for the residents who feared being abandoned with no one to help them with their activities of daily living, such as meals, medications and around-the-clock staffing that they so desperately need.

It is important to note that the MaineCare on which these residents relied was not traditional MaineCare, but an expanded version of coverage unique to these assisted living projects.

The good news is that these elders are safe, at least for the moment. The assisted living facilities are still in business. The residents all had assessments by Goold Health Systems, which were quite confusing and grueling for them. When the care plans materialized, residents feared the worst, as the plans described home-based care services in terms of a few hours a week — certainly not the amount needed.

In reality, however, we are attempting to remain fully staffed and to be able to provide almost comparable services to what was available before July 1.

These home-based care services are paid for completely by state funds. A few of our residents did qualify for private duty nursing through the Medicaid program, which is a mix of two-thirds federal money and one-third state funds. In fact, of all of the residents who were receiving the MaineCare service, only 18 percent were able to remain on a MaineCare program.

While not unexpected to those of us on the front lines, state officials were quite surprised and somewhat dismayed by the number of people who qualified only for state funding. While still considered very low-income, they simply had too high an income to qualify for traditional MaineCare.

As it stands now, the seven affordable assisted living facilities will remain licensed as such, which was a huge relief, and residents will continue to receive the crucial services of around-the-clock care, medication administration and meals.

Before July 1, home-based care and private duty nursing were not available to be used in a licensed assisted living facility. Emergency rules were adopted in July allowing these services in a licensed site while adding new options to the rules specifically for licensed service programs. Fortunately, the rule change also added medication administration as a service for which we fought long and hard. It is a critical part of what we do for our residents. For example, during a routine month, we distribute approximately 30,000 medications to our residents.

In addition to the home-based care and private duty nursing revenue, there were funds dedicated to the seven sites in the governor’s 2009-10 budget. We have been assured that those funds are going to be part of the funding stream for the foreseeable future. We remain hopeful that this is true.

Meanwhile, we have new, complex time-tracking requirements and the residents must adapt to paying for a greater portion of their care. However, when all is said and done, they are able to maintain the quality of life they experienced in June and can stop living in fear that they will have to move or that they will no longer have the solid support system that they require.

We truly appreciate all the public support that was shown to the seniors at these assisted living facilities. The whole ordeal shines a bright light on the state of affairs for low-income seniors who find themselves needing assistance in their old age. As the grayest state in the nation, the time has come to establish a solid strategic plan for the future of Mainers who are aging into the system. This should be a wake-up call.

Noelle Merrill is executive director of the Eastern Area Agency on Aging.